Abstract Pneumonia
Introduction: I will not be looking too deep into this severe case of Community Acquired Pneumonia. My objectives in this case study will basically be to determine whether hospital admission for intravenous antibiotics are necessary. This will be done by using clinical scores and other in-hospital diagnostic criteria to determine prognosis and severity. The relevance to this case study with be treatment regime and a ventilator strategy you may not have heard of.
Case study: 67 year old female of colored ethnicity from wellington, transferred from Paarl hospital intubated, ventilated will host of problems including Chronic Obstructive Pulmonary Disease grade ii , Community Acquired Pneumonia (CAP) , Gastro Intestinal Tract bleed which occurred just before transferring from Paarl, also history of smoking, one packet year, and ethanol (ETOH) abuser.
Conclusion: Diagnostic criteria, is clinical presentation and chest x-ray. The simplest of all clinical scoring system is CURB-65 using 5 prognostic variables to determine the severity of Pneumonia, instead of 20.
Much easier and practical can be applied at patient bedside.
Inverse ratio ventilation to aid and improve filling of non-compliant
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By increasing inspiratory time, mean airway pressure, a primary determinant of oxygenation, is also increased. The use of inverse ratio ventilation to increase mean airway pressure is an option to increasing mean airway with higher inflation pressures, which may be associated with less volutrauma and barotrauma. This mode of ventilation maybe tried in patients who cannot be oxygenated with conventional mechanical ventilation and PEEP or in the presence of prohibitively high peak airway pressures. Inverse ratios of up to 3:1 have been utilized” (Rello & Leeper,